Rh-Matched Transfusion Through Molecular Typing for β-Thalassemia Patients Is Required and Feasible in Chinese

Overview

Journal Transfus Med Hemother

Specialty Hematology

Date 2018 Oct 5

PMID 30283274

Citations 3

Authors

Chao-Peng Shao

Cheng-Jiang Zhao

Chang-Lin Wu

Hua Xu

Xue-Dong Wang

Xiao-Ying Wu

Ping Yi

Xin-Tang Dang

Affiliations

Soon will be listed here.

Abstract

Background: Molecular typing for blood group alleles has been established in many countries for patients and blood donors. In the Chinese literature nearly 80% of transfused patients with alloimmunization have antibodies specific for antigens of the Rh blood group system. We investigated if it is feasible to match packed red blood cells (RBCs) for Chinese β-thalassemia patients by genotyping.

Methods: In this study, 481 patients with β-thalassemia were enrolled. They were genotyped for alleles by a simple PCR method with sequence-specific primers (PCR-SSP). Among these patients, 203 continuously received RBCs of the identical Rh subgroups according to the genotyping results for at least 3 months. Subsequently, their phenotypes were tested through a micro-column gel card method. For validation purposes, 400 donors were serologically typed with the same technology, of which 164 were genotyped too. Finally, the C, c, E, and e frequencies and the feasibility of the simple genotyping method were analyzed.

Results: All patients showed mixed-field agglutination in the Rh subgroup gel cards before the same Rh subgroups in blood donors were selected for blood transfusion. The results, however, lacked mixed-field agglutination in all 203 cases after transfusion with RBC concentrates selected for the patient's C, c, E, and e antigens for at least 3 months. The genotyping results of 164 donors were all consistent with the serological results. Whole coding regions of were sequenced in 7 individuals with weak c, E, or e antigens. In only one sample we observed a 1059G>A nucleotide mutation coding for a truncated RhCE polypeptide (GenBank KT957625), in the other 6 samples no sequence variant was found. Both patients and donors were predominantly CcEe and CCee, with a prevalence of 55.3% and 24.9% for patients or 49.3% and 31.3% for donors, respectively. It revealed that about 80% of Chinese could receive Rh-matched RBCs easily.

Conclusion: A simple genotyping technique is safe enough for Rh-matched transfusion of β-thalassemia patients in Chinese Han.

Citing Articles

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Towards a Regional Registry of Extended Typed Blood Donors: Molecular Typing for Blood Group, Platelet and Granulocyte Antigens.

Portegys J, Rink G, Bloos P, Scharberg E, Kluter H, Bugert P Transfus Med Hemother. 2018; 45(5):331-340.

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Optimized Antigen Matching - Chances and Challenges in Molecular Times.

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